[Mechanisms of resistance to anti-BRAF treatments]

Ann Dermatol Venereol. 2014 Nov;141(11):671-81. doi: 10.1016/j.annder.2014.06.021. Epub 2014 Aug 7.
[Article in French]

Abstract

Context: In patients with melanoma positive for the BRAF V600 mutation, clinical response to specific BRAF inhibitors is usually rapid and striking, with significant benefits in terms of progression-free survival and overall survival. However, resistance to treatment almost invariably arises, typically within a median timeframe of 6 months. Indeed, very few patients exhibit long-lasting response to these targeted therapies.

Aims: It is essential to better understand the mechanisms of resistance to targeted anti-BRAF therapies in order to increase both response rates and the duration of clinical response to treatment. This literature review describes the signaling pathways involving BRAF and presents recent data from clinical trials with these molecules. Furthermore, we aim to describe the main resistance mechanisms linked with targeted anti-BRAF therapies.

Methods: The keywords (resistance, BRAF, melanoma, targeted therapy, vemurafenib, and dabrafenib) were used to extract relevant articles in the Medline/Pubmed database published before 31 January 2014.

Discussion: Improved knowledge and understanding of the mechanisms of resistance to targeted anti-BRAF therapies should enable the development of new therapeutic strategies in order to overcome such resistance and allow more significant and sustained response rates to be achieved among melanoma patients.

Keywords: BRAF; Dabrafenib; Melanoma; Mutation; Mélanome; Resistance; Résistance; Targeted therapy; Thérapie ciblée; Vemurafenib.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Drug Resistance, Neoplasm*
  • Humans
  • Imidazoles / therapeutic use
  • Indoles / therapeutic use
  • Melanoma / drug therapy*
  • Melanoma / genetics
  • Molecular Targeted Therapy
  • Mutation / genetics
  • Oximes / therapeutic use
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*
  • Proto-Oncogene Proteins B-raf / genetics
  • Sulfonamides / therapeutic use
  • Valine / genetics
  • Vemurafenib

Substances

  • Antineoplastic Agents
  • Imidazoles
  • Indoles
  • Oximes
  • Sulfonamides
  • Vemurafenib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Valine
  • dabrafenib